Medical hypothesis discovery and innovation in ophthalmology

Abstract

In order to determine the effect of intracorneal rings (Intacs SK), when implanted in keratoconic patients, on corneal curvature, Uncorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA) and on the progression of the cone through three years follow-up period. In this prospective nonrandomized study 114 eyes of 71 keratoconic patients (38 females and 33 males) were implanted with Intacs SK. Incisions were always made in the steep meridian. UCVA, BCVA, Corneal Topography (TMS) were measured pre and postoperatively and at intervals of 1, 3, 6 & 12 months then yearly for 3 consecutive years. Preoperative mean k-reading was 52.53 and 48.18, 49.56, 49.17, 48.51, 48.15 & 48.01 at 1, 3, 6, 12, 24 & 36 months postoperatively (P‹0.01). In terms of UCVA, 15.64% of patients gained more than 3 lines and 69.73% gained 1-3 lines with a total of 85.37% of patients gaining lines compared to their preoperative UCVA (P‹0.01) while 14.63% of cases did not gain any lines at 1 month postoperative. At three months postoperatively, 12.64% gained more than 3 lines, 71.15% gained 1-3 lines with a total of 83.79% while 16.21% did not gain any lines. Three years postoperative 11.82% of cases gained more than 3 lines, 73.23% gained 1-3 lines with a total of 85.05% while 14.95% did not gain any lines (P‹0.01). With regard to BCVA, 19.73% gained more than 3 lines, 68.26% gained 1-3 lines with a total of 87.99% of cases gaining lines compared to their preoperative BCVA (P‹0.01) while 12.01% did not gained any lines at 1 month postoperative. At three months postoperatively, 14.96% gained more than 3 lines, 70.19% gained 1-3 lines with a total of 85.15% while 14.85% did not gain any lines. Three years postoperative, 12.17% gained more than 3 lines, 71.78% gained 1-3 lines with a total of 83.95% (P‹0.01) while 16.05% did not gain any lines. No eyes lost any lines as it pertained to UCVA & BCVA. Despite the fluctuation of k-readings, UCVA and BCVA in the first 3 months, which may represent the time needed to stabilize the cone, UCVA and BCVA were improved and maintained throughout the study. Patient selection remains the key point for the success of intacs in keratoconic patients.